Bipolar gene test stirs debate over at-home diagnostic kits

Experts say they are based on thin data, prey on fears

Marcus Wohlsen, Associated Press Writer

Published 4:00 am, Monday, March 24, 2008

Photo: Lenny Ignelzi

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Dr. John Kelsoe, co-founder of Psynomics, explains his research in a laboratory at the University of California-San Diego as faculty member Dr. Xianjin Zhou works behind, Thursday, Feb. 28, 2008 in San Diego. Kelsoe has spent his career trying to identify the biological roots of bipolar disorder. (AP Photo/Lenny Ignelzi) less

Dr. John Kelsoe, co-founder of Psynomics, explains his research in a laboratory at the University of California-San Diego as faculty member Dr. Xianjin Zhou works behind, Thursday, Feb. 28, 2008 in San Diego. ... more

Photo: Lenny Ignelzi

Bipolar gene test stirs debate over at-home diagnostic kits

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Dr. John Kelsoe has spent his career trying to identify the biological roots of bipolar disorder. In December, he announced he had discovered several gene mutations closely tied to the disease, also known as manic depression.

Then Kelsoe, a prominent psychiatric geneticist at the UC San Diego, did something provocative for the buttoned-down world of academic medical research: He began selling bipolar genetic tests straight to the public over the Internet last month for $399.

His company, Psynomics of La Jolla (San Diego County), joins a legion of startups racing to exploit the boom in research connecting genetic variations to a host of health conditions. More than 1,000 at-home gene tests have burst onto the market in the past few years.

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The proliferation of these tests troubles many public health officials, medical ethicists and doctors. The tests receive almost no government oversight, even though many of them are being sold as tools for making serious medical decisions.

Health experts worry that many of these products are built on thin data and are preying on individuals' deepest anxieties.

Tests have become available claiming to help predict and diagnose everything from serious illnesses like cancer and Alzheimer's to athletic ability and a person's ideal diet. Psynomics' offering is one of the first psychiatric gene tests on the market.

Kelsoe, 52, acknowledges that bipolar disorder probably results from a combination of genetic factors and life experiences, and that the presence of these gene variations does not at all mean that someone will, in fact, develop the disease. He admits, too, that his findings about the genetic basis of the illness are far from complete.

But he said his test is a vital starting point toward moving away from the notoriously tricky practice of diagnosing bipolar disorder based purely on a person's behavior.

To take the test, patients receive by mail a plastic cup that they spit into, seal and send back to Psynomics. The company analyzes DNA in the saliva.

Psynomics will send patients' test results only to their doctors to avoid the risk of self-diagnosis.

The report that accompanies those results instructs doctors that a positive test means patients are two to three times more likely to have bipolar disorder. But the studies from which those figures come also show the gene variations themselves are rare even among those with bipolar.

The report also points out that for now, the test is valid only for whites of Northern European ancestry who show some behavioral symptoms and have at least one other bipolar family member.

Psynomics has sold only a few tests so far but is projecting sales of 1,800 tests in 2008 and 30,000 in the next five years.

In coming months, at least two other startups led by genetic researchers are set to release their own psychiatric genetic tests. One test claims to predict the risk of developing schizophrenia. The other is designed to forecast the likelihood that some medications for major depression could heighten suicidal thoughts in patients.